Your Doctor's Office Checklist

Intro

Lifestyle measures certainly play a significant role in health maintenance, but when you enter your 50s and beyond, getting the vital screening tests is very important.

Think of it this way: While calcium and vitamin D help fight bone loss, if a bone-density scan finds that you have low bone mass, your doctor can put you on protective therapy early to fight it.

If a breast tumor is found with a mammogram or breast exam, the earlier it's detected, the easier it is to treat and cure. (Your risk of dying from breast cancer rises with age--although it's still a distant third behind heart disease and lung cancer for women in general. When you were 35, your chance of getting breast cancer was only one in 622. By age 60, the relative risk is one in 24, although the risk varies greatly from woman to woman.)

The scale presents another challenge. It's getting harder and harder to keep your weight down. You need to put strategies into place to keep calories in check--whether it's through taking in smaller portions or bulking up with fiber.Our Doctor's Office Checklist pays special attention to conditions to watch for and medical screens and tests that can help you detect and manage small problems before they become unmanageable.Clip out the checklist and hang it on the fridge or carry it in your handbag. (For more health care solutions, cross-reference our Self-Care Checklist.)[pagebreak]

What You Should Track

Height measurement You should be getting your height measured every time you're at the doctor's office, or at least once a year. Over your lifetime, a gradual loss of about 1.5 inches is normal. But if you've lost more height than that--or you've lost an inch and a half in 10 years or less--it could indicate vertebral compression fractures as a result of osteoporosis.

Bone-density test Get a bone-density measurement if you're in menopause or past menopause and you've never had a test. Out of the 25 million Americans who have osteoporosis, 80 percent are women.

The best measurement for women is a DEXA scan of the spine and the hip, the two places that usually have the most serious fractures. The spine is also where the first bone loss most often occurs after menopause. Some rural areas don't have the machine. In that case, an ultrasound of the heel or a dual or single x-ray of the arm or finger will measure your bone density.

25-hydroxy vitamin D serum level check If you're older than 49, especially if you're at risk for osteoporosis, have your level of vitamin D checked. Vitamin D helps calcium get absorbed in the body. Your levels should be over 20 nanograms per liter.

Dental checkup Go to the dentist every 6 months, or more often if you experience pain or other problems.

Eye exams Go for a comprehensive eye examination, if you have not already done so. You should be getting an eye exam every 2 to 4 years, or sooner if you notice a change in your vision.

Serum ferritin test and transferrin saturation test You were tested at age 18 for hemochromatosis, an iron overload disease. After menopause is a good time to get tested again. Talk to your physician about the most current recommendations regarding these tests.

Skin exams Don't let up on those annual skin exams.

Blood pressure check Get your blood pressure checked at least every 2 years, more often if it's abnormal.

Complete lipid profile Now more than ever, it's important to have your cholesterol checked at least every 2 years; every 4 months if it's abnormal. Women typically get cardiovascular disease 10 to 15 years later than men, when they experience the postmenopausal loss of estrogen. Also, cholesterol levels change after menopause. Bad LDL cholesterol levels go up, while good HDL cholesterol levels go down, putting postmenopausal women at greater risk for cardiovascular disease.

Thyroid-stimulating hormone test Don't forget to get screened every 5 years for an underactive or overactive thyroid.

Pelvic exam, Pap test, and breast exam Don't stop getting Pap tests when you stop menstruating. The exam could detect cancer. Even if you've had a hysterectomy and your ovaries were taken out, you still need a pelvic exam. This is true even though you may have always had normal Pap test results and are monogamous. The pelvic exam can be helpful with other problems, such as incontinence, genital itching, sores, or painful intercourse.

Mammogram Continue to get an annual mammogram.

Colorectal screening Colorectal cancer is the third-most-common cancer among American women, but it's almost always curable if found early enough. If everyone started getting regular screenings for colon cancer at age 50, about 25,000 lives a year could be spared from the disease.

Make sure your annual pelvic exam includes a digital rectal exam, starting at age 50. Also, get a colonoscopy at age 50 and every 10 years thereafter--or ask your doctor if you can opt for flexible sigmoidoscopy every 3 to 5 years. In addition, get a yearly fecal occult blood test.

Risk factors for colon cancer include:

A family history

A genetic predisposition

Chronic inflammatory bowel disease

A previous history of colon polyps or colon cancer

Watch out for rectal bleeding, blood in stool, or a change in bowel habits.

Low-dose CAT scan Lung cancer kills more Americans than any other cancer, and it's usually not diagnosed until it's too far along to treat. Annual low-dose CAT scans in women 60 or older who smoke now or smoked in the past may be able to detect tumors while small enough to be treated.

Flu shot Everyone over age 50--except those allergic to eggs or the flu vaccine--should get a flu shot each September or October. If you're healthy, the shot can prevent illness, and if you have a chronic medical condition, such as asthma, it can reduce the flu's severity and risk of serious complications.

Tetanus shot Two out of three people over age 60 haven't gotten a tetanus shot in the past 10 years, which means they're not immune to tetanus. If you're one of those people, make sure you get the shot.

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